Sunday, September 28, 2008

Reminiscing My Stay At OBAS

Yesterday's Philippine Daily Inquirer contained a treat: A Youngblood article narrating a normal day at the Philippine General Hospital's OB Admitting Section.

Four years after graduating from UPCM, it's interesting to see how much things have remained the same.

My last duty as a clinical clerk was notable for it being particularly hellish. As "initiates" into the medical profession, we had to assist in more caesarian sections ("CS") so that the interns would be able to do more normal deliveries - in order to satisfy licensure requirements.

It was a Tuesday, and not a "high-risk" day (Mondays and Fridays are, because the Out Patient Department sends patients to the OBAS for delivery). But it sure felt like one. If my memory serves me right, we admitted close to 60 patients that day - with more than half for CS. The delivery team (which is separate from the admitting team, who draws blood, interviews and examines patients before they are wheeled in for labor monitoring and delivery) of 5 interns and 2 clerks had a field day. Each had at least 6 patients to their name. It was a relief that we had the good fortune of not running out of water or supplies at that time - we would endure shortages the next year.

Since it was our last day before our next rotation in Surgery, we were not able to attend the 7am roasting, I mean Endorsement sessions. I would just imagine how we would be able to present our complicated cases without complete data - because most of the time, we would be monitoring patients and assisting residents in the OR.

Yes friends, we had to keep a stash of vials, syringes, even IV fluids and catheters. Yes, our residents (well, later when the autoclave machine started breaking down and the wards were literally packed with patients) had to shell out thousands for laparotomy packs, antibiotics, and even surgical sutures.

I've had my share of patients who did not think of having a prenatal check-up, much less family planning. Patients as young as 15 giving birth. Patients who are on their 8th pregnancy.

My classmates and I had to endure this for 24 hours (or more, if your duty ends with a patient's progress of labor still not "resolved") without sleep or even food. Usually we have food delivered, and we try to sneak a bite when there is a break in the action - 30 minutes of free time is a luxury. At the end of it all, you go to the wards to finish paperwork after endorsements and rest, because after 2 days you'll go on duty again.

It was one of my bloodiest rotations ever. Literally. Universal Precautions for handling blood and other body fluids? The hospital does not even have enough sterile gloves - we have the patients' companions buy at least 3 pairs. And a lot of us have had blood spilled on our white uniforms and on our hands. Try drawing blood, inserting an IV line, and a urethral catheter within 10 minutes to a preeclamptic patient - a lot of things can happen.

We had a lot of students getting Hepatitis B exposure because in the rush of getting patients admitted, the patient is not able to disclose their Hepatitis B positive status. Imagine if you had an HIV-positive patient and you did not know about it until later.

These are the articles that parents and students contemplating to study in the UP College of Medicine have to read about. With Return Service Obligation, this would be a lifestyle that only the bravest could endure for 8 years or more. If you will make this decision, I salute you. Only because our ungrateful nation would not.

We are not heroes. We are helpless individuals caught in the middle.

Nothing could be farther from the truth.

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